Abdominal wall defects or hernias are commonly repaired using a physiologically compatible synthetic mesh such as a polytetrafluoroethylene mesh, polypropylene mesh, and the like. Tension-free mesh repair of hernias is preferred over conventional suture closure, which often results in the creation of significant tension and subsequent recurrence of the hernia. More recently, video-assisted (laparoscopic) technology has been utilized to repair the abdominal wall defects from a posterior (from inside the abdomen) position, thus offering the potential for a lower incidence of subsequent recurrence of the hernia. Where the laparoscopic technique is utilized, the synthetic mesh is typically secured against the abdominal wall using surgical tacks of various types, for example of the type disclosed in U.S. Pat. Nos. 5,728,116 and 6,036,701, and also of the Q-ring type commercially available from Onux Medical, Inc. of Hampton, N.H.
One of the challenges encountered during laparoscopic hernia repair is the placement of the mesh and the tacks in the precisely intended location to provide adequate overlap of the mesh with the surrounding abdominal wall tissue. With each application of an additional surgical tack, repositioning of the mesh (when necessary) becomes more and more difficult, if not impossible. In addition, during the early process of tacking the mesh to the abdominal wall, the field of view is often significantly hindered by the partially dangling piece of mesh. This limitation may reach unsafe levels in cases of large abdominal wall defects requiring large pieces of mesh, with significant potential for inadvertent injury to abdominal organs.
There is, therefore, a need for improving the existing technique of laparoscopic hernia repair through the use of a tack or the like that would allow placement of the tacks before obliteration of the view by the mesh, and subsequent near-perfect positioning and repositioning of the mesh as needed.